Abstract
BackgroundIn Spain, more than 85% of coronary heart disease deaths occur in adults older than 65 years. However, coronary heart disease incidence and mortality in the Spanish elderly have been poorly described. The aim of this study is to estimate the ten-year incidence and mortality rates of myocardial infarction in a population-based large cohort of Spanish elders.MethodsA population-based cohort of 3729 people older than 64 years old, free of previous myocardial infarction, was established in 1995 in three geographical areas of Spain. Any case of fatal and non-fatal myocardial infarction was investigated until December 2004 using the "cold pursuit method", previously used and validated by the the WHO-MONICA project.ResultsMen showed a significantly (p < 0.001) higher cumulative incidence of myocardial infarction (7.2%; 95%CI: 5.94-8.54) than women (3.8%; 95%CI: 3.06-4.74). Although cumulative incidence increased with age (p < 0.05), gender-differences tended to narrow. Adjusted incidence rates were higher in men (957 per 100 000 person-years) than in women (546 per 100 000 person-years) (p < 0.001) and increased with age (p < 0.001). The increase was progressive in women but not in men. Adjusted mortality rates were also higher in men than in women (p < 0.001), being three times higher in the age group of ≥ 85 years old than in the age group of 65-74 years old (p < 0.001).ConclusionIncidence of fatal and non-fatal myocardial infarction is high in the Spanish elderly population. Men show higher rates than women, but gender differences diminish with age.
Highlights
In Spain, more than 85% of coronary heart disease deaths occur in adults older than 65 years
Incidence studies conducted in Spain indicate that Coronary heart disease (CHD) is a frequent disease in the general population, with rates in order of 200 new myocardial infarctions per 100,000 men-year and 50 per 100,000 women-year respectively[5] The higher incidence can be observed in the eldest age group
We considered Definite myocardial infarction (MI) in those subjects who presented a definite ECG or typical/atypical symptoms, together with a probable ECG and abnormal enzymes, or those with typical symptoms, abnormal enzymes and ischemic ECG
Summary
In Spain, more than 85% of coronary heart disease deaths occur in adults older than 65 years. Coronary heart disease incidence and mortality in the Spanish elderly have been poorly described. The aim of this study is to estimate the ten-year incidence and mortality rates of myocardial infarction in a population-based large cohort of Spanish elders. Coronary heart disease (CHD) is the main cause of death in the industrialized countries[1], and myocardial infarction (MI) the most dominant manifestation of the disease. Incidence studies conducted in Spain indicate that CHD is a frequent disease in the general population, with rates in order of 200 new myocardial infarctions per 100,000 men-year and 50 per 100,000 women-year respectively[5] The higher incidence can be observed in the eldest age group. The impact of striking demographic changes in the Spanish elderly population, with an increase of ten million elders during the last decade, and its effect on CHD incidence and mortality needs to be evaluated
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